Sotos syndrome is characterized by overgrowth features and is caused by alterations in the nuclear receptor binding SET domain protein 1 gene.Attentiondeficit/hyperactivity disorder(ADHD)is considered a neurodevelopme...Sotos syndrome is characterized by overgrowth features and is caused by alterations in the nuclear receptor binding SET domain protein 1 gene.Attentiondeficit/hyperactivity disorder(ADHD)is considered a neurodevelopment and psychiatric disorder in childhood.Genetic characteristics and clinical presentation could play an important role in the diagnosis of Sotos syndrome and ADHD.Magnetic resonance imaging(MRI)has been used to assess medical images in Sotos syndrome and ADHD.The images process is considered to display in MRI while wavelet fusion has been used to integrate distinct images for achieving more complete information in single image in this editorial.In the future,genetic mechanisms and artificial intelligence related to medical images could be used in the clinical diagnosis of Sotos syndrome and ADHD.展开更多
Attention-deficit/hyperactivity disorder(ADHD)is one of the most common neurodevelopmental disorders of childhood,yet its diagnosis remains complex and fraught with challenges.Pediatricians,often the first point of co...Attention-deficit/hyperactivity disorder(ADHD)is one of the most common neurodevelopmental disorders of childhood,yet its diagnosis remains complex and fraught with challenges.Pediatricians,often the first point of contact for concerned families,play a pivotal role in the diagnostic process.However,they face numerous obstacles that can hinder accurate and timely diagnosis,particularly in resource-limited or culturally diverse settings such as the Middle East and North Africa(MENA)and Arabian Gulf regions.This narrative review explores the key challenges pediatricians face in diagnosing ADHD and highlights practical and emerging solutions.The article offers both a global perspective and a contextualized view relevant to the MENA region.A narrative literature review was conducted using PubMed,Scopus,and Google Scholar,focusing on peer-reviewed studies,clinical guidelines,and epidemiological data from 2010 to 2025 related to pediatric ADHD diagnosis,especially in MENA regions.The review identifies six major diagnostic barriers:(1)Symptom overlap with other conditions[e.g.,autism spectrum disorder(ASD),anxiety,learning disabilities];(2)Reliance on subjective informant reports;(3)Cultural and societal influences including stigma and gender bias;(4)Variability in ADHD training and time constraints in clinical practice;(5)Limited access to multidisciplinary evaluations;and(6)Systemic referral and communication inefficiencies.Comorbidities are highly prevalent and frequently complicate the diagnostic picture.Delayed or inaccurate diagnosis can lead to academic underperformance,family stress,missed interventions,and long-term psychological consequences.Emerging solutions include digital screening tools,artificial intelligence-assisted analysis,structured reporting platforms,and improved training and referral models.Regional data from the Arabian Gulf highlight variable prevalence rates(1.3%-22%)and underscore the need for culturally sensitive diagnostic strategies.To improve diagnostic accuracy and patient outcomes,pediatricians must be supported through better training,interdisciplinary collaboration,validated tools,and policy-level reforms.Tailoring these approaches to local contexts will be key to addressing the growing burden of ADHD,particularly in the MENA region.展开更多
Attention-deficit/hyperactivity disorder(ADHD)is increasingly conceptualized as a dynamic neurodevelopmental condition,marked by fluctuating symptom trajectories across development rather than the traditional static p...Attention-deficit/hyperactivity disorder(ADHD)is increasingly conceptualized as a dynamic neurodevelopmental condition,marked by fluctuating symptom trajectories across development rather than the traditional static patterns of persistence or remission.This review synthesizes empirical evidence on the varied trajectories of ADHD symptoms-including late-onset,partial remission,and recurrent fluctuation patterns-and underscores their clinical significance in longterm functioning.We adopt a multifactorial framework to explore how genetic,environmental,and gene–environment interactions contribute to the emergence and evolution of ADHD symptoms over time.In addition,we consider how medication-related variables-particularly tolerance and adherence-may influence symptom fluctuation.Characterizing these developmental dynamics offers critical guidance for designing flexible,personalized interventions that align with individual trajectories and transitional vulnerabilities.展开更多
BACKGROUND Sotos syndrome is an autosomal dominant disorder,whereas attention-deficit/hyperactivity disorder(ADHD)is a neurodevelopmental condition.This report aimed to summarize the clinical and genetic features of a...BACKGROUND Sotos syndrome is an autosomal dominant disorder,whereas attention-deficit/hyperactivity disorder(ADHD)is a neurodevelopmental condition.This report aimed to summarize the clinical and genetic features of a pediatric case of Soros syndrome and ADHD in a child exhibiting precocious puberty.CASE SUMMARY The patient presented with accelerated growth and advanced skeletal maturation;however,she lacked any distinct facial characteristics related to specific genetic disorders.Genetic analyses revealed a paternally inherited heterozygous synonymous mutation[c.4605C>T(p.Arg1535Arg)].Functional analyses suggested that this mutation may disrupt splicing,and bioinformatics analyses predicted that this mutation was likely pathogenic.After an initial diagnosis of Sotos syndrome,the patient was diagnosed with ADHD during the follow-up period at the age of 8 years and 7 months.CONCLUSION The potential for comorbid ADHD in Sotos syndrome patients should be considered to avoid the risk of a missed diagnosis.展开更多
Background: Working memory is an executive function that plays an important role in many aspects of daily life, and its impairment in patients with attention-deficit/hyperactivity disorder (ADHD) affects quality of li...Background: Working memory is an executive function that plays an important role in many aspects of daily life, and its impairment in patients with attention-deficit/hyperactivity disorder (ADHD) affects quality of life. The dorsolateral prefrontal cortex (DLPFC) has been a good target site for transcranial direct current stimulation (tDCS) due to its intense involvement in working memory. In our 2018 study, tDCS improved visual-verbal working memory in healthy subjects. Objective: This study examines the effects of tDCS on ADHD patients, particularly on verbal working memory. Methods: We conducted an experiment involving verbal working memory of two modalities, visual and auditory, and a sustained attention task that could affect working memory in 9 ADHD patients. Active or sham tDCS was applied to the left DLPFC in a single-blind crossover design. Results: tDCS significantly improved the accuracy of visual-verbal working memory. In contrast, tDCS did not affect auditory-verbal working memory and sustained attention. Conclusion: tDCS to the left DLPFC improved visual-verbal working memory in ADHD patients, with important implications for potential ADHD treatments.展开更多
Attention-deficit/hyperactivity disorder （ADHD） is a neurodevelopmental disorder with a long-term impact on functioning, productivity and quality of life of patients. This impact is largely due to the symptoms of in...Attention-deficit/hyperactivity disorder （ADHD） is a neurodevelopmental disorder with a long-term impact on functioning, productivity and quality of life of patients. This impact is largely due to the symptoms of inattentiveness. However, despite its impairing role in the lives of ADHD patients, inattentiveness has been studied relatively less frequently than have symptoms of impulsivity/hyperactivity and problems with executive function. This review therefore seeks to integrate the neuropsychological theories and current findings in the research fields of neuropsychology, neurophysiology, and neuroimaging, in an attempt to gain a more complete understanding of the role that inattentiveness plays in ADHD, as well as to suggest directions for future studies. The need for a more comprehensive understanding of inattentiveness and ADHD, which integrates findings from each of the three disciplines mentioned above, is emphasized.展开更多
Regional homogeneity（ReHo）and the amplitude of low-frequency fluctuation（ALFF）are two approaches to depicting different regional characteristics of resting-state functional magnetic resonance imaging（RS-fMRI）dat...Regional homogeneity（ReHo）and the amplitude of low-frequency fluctuation（ALFF）are two approaches to depicting different regional characteristics of resting-state functional magnetic resonance imaging（RS-fMRI）data.Whether they can complementarily reveal brain regional functional abnormalities in attention-deficit/hyperactivity disorder（ADHD）remains unknown.In this study,we applied ReHo and ALFF to 23 medication-na ve boys diagnosed with ADHD and 25 age-matched healthy male controls using whole-brain voxel-wise analysis.Correlation analyses were conducted in the ADHD group to investigate the relationship between the regional spontaneous brain activity measured by the two approaches and the clinical symptoms of ADHD.We found that the ReHo method showed widely-distributed differences between the two groups in the fronto-cingulo-occipitocerebellar circuitry,while the ALFF method showed a difference only in the right occipital area.When a larger smoothing kernel and a more lenient threshold were used for ALFF,more overlapped regions were found between ALFF and ReHo,and ALFF even found some new regions with group differences.The ADHD symptom scores were correlated with the ReHo values in the right cerebellum,dorsal anterior cingulate cortex and left lingual gyrus in the ADHD group,while no correlation was detected between ALFF and ADHD symptoms.In conclusion,ReHo may be more sensitive to regional abnormalities,at least in boys with ADHD,than ALFF.And ALFF may be complementary to ReHo in measuring local spontaneous activity.Combination of the two may yield a more comprehensive pathophy-siological framework for ADHD.展开更多
This study retrospectively analyzed the medication prescriptions of children diagnosed with attention-deficit/hyperactivity disorder(ADHD) in Ningbo Psychiatric Hospital and Ningbo Women and Children’s Hospital from ...This study retrospectively analyzed the medication prescriptions of children diagnosed with attention-deficit/hyperactivity disorder(ADHD) in Ningbo Psychiatric Hospital and Ningbo Women and Children’s Hospital from March 2018 to September 2020 and compared the drug retention rate of methylphenidate hydrochloride and atomoxetine hydrochloride. The prescription automatic screening system was used to screen the prescriptions in children with ADHD. Kaplan-Meier regression analysis was used to compare prescription retention rates between the two regimens after adjusting for gender, age, body weight, and prescription cost. The mean age of the methylphenidate hydrochloride group was 8.75 ± 2.16 years, and the monthly prescription cost was 327.37 ± 146.64 RMB. The average age of the atomoxetine group was 8.33 ± 1.73 years, and the monthly prescription cost was 363.15 ± 154.90 ￥. There were some differences in the age of enrollment and the monthly prescription cost between the two regimens(all P < 0.01). Moreover, the retention rate of methylphenidate hydrochloride was higher compared with atomoxetine hydrochloride within 18 months. Kaplan-Meier regression analysis showed that this trend was significant(Tarone-ware, Chi-square value = 14.893, P < 0.001). Prescription costs might be a factor affecting drug retention. This study found that the retention rates were decreased month by month in children with ADHD, and after 5 months, the retention rates were 52.20% and 41.22%, respectively, far below the recommended levels of the guidelines.展开更多
AIM To investigate suicidality and attention-deficit/hyperactivity disorder(ADHD),this paper aims to systematically review the literature as an extension of previous reviews.METHODS We searched five databases(Ovid MED...AIM To investigate suicidality and attention-deficit/hyperactivity disorder(ADHD),this paper aims to systematically review the literature as an extension of previous reviews.METHODS We searched five databases(Ovid MEDLINE,Psychinfo,PubM ed,Scopus,Web of Science)with two categories of search terms:(1)suicide;suicidal;suicide behavior;suicide attempt;suicidal thought;and(2)ADHD.RESULTS The search resulted 26 articles.There is a positive association between ADHD and suicidality in both sexes and in all age groups.Comorbid disorders mediate between suicidality and ADHD.CONCLUSION Recognizing ADHD,comorbid conditions and suicidality is important in prevention.展开更多
BACKGROUND High risk of alcohol and drug use disorders in people with attentiondeficit/hyperactivity disorder(ADHD)calls for exploratory research of relationships with clinical features of ADHD.AIM To estimate prevale...BACKGROUND High risk of alcohol and drug use disorders in people with attentiondeficit/hyperactivity disorder(ADHD)calls for exploratory research of relationships with clinical features of ADHD.AIM To estimate prevalence of alcohol/drug use disorders and associations with ADHD symptom severity and emotional dysregulation,in adults with ADHD.METHODS This observational cross-sectional clinical study consisted of patients admitted to a private psychiatric outpatient clinic in Oslo,Norway(2014-2018).Five-hundred and fifty-eight eligible patients diagnosed with ADHD(Diagnostic and Statistical Manual of Mental Disorders,Fifth Edition(DSM-5)criteria)agreed to participate.Alcohol and drug use disorders were diagnosed using the Mini International Neuropsychiatric Interview(MINI).Dependence and abuse were merged into“use”disorder as in MINI version 7.0/DSM-5.Questions were related both to lifetime and the past 12-mo.ADHD severity was assessed by the Adult ADHD Self Report Scale(ASRS).Subdivisions of the ASRS questionnaire as inattentive items and hyperactive/impulsivity items were recorded separately.Emotional dysregulation was assessed by the eight-item version of Barkley’s Current Behavior Scale-Self Report.RESULTS The 12-mo prevalence was 5.3%for alcohol use disorder and 13.7%for drug use disorder.The lifetime prevalence was 12.0%for alcohol use disorder and 27.7%for drug use disorder.Men had higher rates of both alcohol use disorder and drug use disorder compared to women.The prevalence of drug use disorder was more than twice that of alcohol use disorder for both sexes.The drugs most participants reported having used were(in descending order):Amphetamine(19.1%),cannabis(17.1%),cocaine or ecstasy(7.4%),benzodiazepines(7.4%),and heroin or other opioids(2.9%).Lifetime drug use disorder was significantly associated with both hyperactivity-impulsivity symptoms and emotional dysregulation symptom severity.Lifetime alcohol use disorder,on the other hand,was not significantly associated with ADHD symptoms or emotional dysregulation when adjusted for gender and age.CONCLUSION Patients with ADHD have a high lifetime prevalence of drug use disorder,which is associated with higher levels of hyperactivity-impulsivity symptoms and emotional dysregulation.展开更多
BACKGROUND Treatment efficacy for attention-deficit/hyperactivity disorder(ADHD)is reported to be poor,possibly due to heterogeneity of ADHD symptoms.Little is known about poor treatment efficacy owing to ADHD heterog...BACKGROUND Treatment efficacy for attention-deficit/hyperactivity disorder(ADHD)is reported to be poor,possibly due to heterogeneity of ADHD symptoms.Little is known about poor treatment efficacy owing to ADHD heterogeneity.AIM To use generalized structural equation modeling(GSEM)to show how the heterogeneous nature of hyperactivity/impulsivity(H/I)symptoms in ADHD,irritable oppositional defiant disorder(ODD),and the presentation of aggression in children interferes with treatment responses in ADHD.METHODS A total of 231 children and adolescents completed ADHD inattention and H/I tests.ODD scores from the Swanson,Nolan,and Pelham,version IV scale were obtained.The child behavior checklist(CBCL)and parent’s satisfaction questionnaire were completed.The relationships were analyzed by GSEM.RESULTS GSEM revealed that the chance of ADHD remission was lower in children with a combination of H/I symptoms of ADHD,ODD symptoms,and childhood aggressive behavior.ODD directly mediated ADHD symptom severity.The chance of reaching remission based on H/I symptoms of ADHD was reduced by 13.494%[=exp(2.602)]in children with comorbid ADHD and ODD[odds ratio(OR)=2.602,95%confidence interval(CI):1.832-3.373,P=0.000]after adjusting for the effects of other factors.Childhood aggression mediated ODD symptom severity.The chance of reaching remission based on ODD symptoms was lowered by 11.000%[=1-exp(-0.117)]in children with more severe baseline symptoms of aggression based on the CBCL score at study entry[OR=-0.117,95%CI:(-0.190)-(-0.044),P=0.002].CONCLUSION Mediation through ODD symptoms and aggression may influence treatment effects in ADHD after adjusting for the effects of baseline ADHD symptom severity.More attention could be directed to the early recognition of risks leading to ineffective ADHD treatment,e.g.,symptoms of ODD and the presentation of aggressive or delinquent behaviors and thought problems in children with ADHD.展开更多
Background: Informed consent forms and clinical study participation explanations contain many specialized words including medical terms that are difficult to understand. The difficulty is particularly obvious for chil...Background: Informed consent forms and clinical study participation explanations contain many specialized words including medical terms that are difficult to understand. The difficulty is particularly obvious for children with developmental disorders who show attention or similar problems. This study quantitatively evaluated the decision-making ability of these children using the Wechsler Intelligence Scale for Children-III (WISC-III) as a preliminary study for a multi-faceted investigation that would also use physiological indices. Methods: Participants were 11 children with Attention Deficit/Hyperactivity Disorder (AD/HD). The WISC-III was used for quantitative evaluation of their decision-making ability. Results of intelligence quotients (IQs), group indices, and subtest scores were analyzed. Results: The mean Performance IQ was four points lower than the mean Verbal IQ. The mean score for the Processing Speed index was lower by more than one standard deviation (SD). The mean scores for the Coding and Object Assembly subtests were lower by more than two SDs. Conclusion: The WISC-III results for IQ and group indices suggested the efficacy of auditory explanations. In addition, the subtest results suggested the necessity to pay sufficient attention to risk-benefit weighting in explanations. These findings suggested that the decision-making ability of children with AD/HD could be assessed using the WISC-III.展开更多
Aims: This study was designed to verify the proportion of Japanese adults with pervasive developmental disorder (PDD) who met the diagnostic criteria (other than E) for attention-deficit/hyperactivity disorder (ADHD) ...Aims: This study was designed to verify the proportion of Japanese adults with pervasive developmental disorder (PDD) who met the diagnostic criteria (other than E) for attention-deficit/hyperactivity disorder (ADHD) in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR). Furthermore, we examined to what extent adults with PDD think that they exhibit ADHD symptoms. Methods: We developed an original Japanese self-report questionnaire to determine the presence or absence of 18 symptoms from the diagnostic criteria for ADHD in the DSM-IV-TR. We administered the questionnaire to 64 adults with high-functioning PDD (45 men and 19 women) and 21 adults with ADHD (10 men and 11 women), aged 18 to 59 years, with a full-scale intelligence quotient ≥75. Target patients were evaluated for ADHD by their psychiatrists. Results: Twenty-nine (45.3%) adults with PDD also had ADHD. The percentage of these adults who had over six perceived inattention symptoms from the DSM-IV-TR was 96.6%. The percentage of these adults who had over six perceived hyperactivity-impulsivity symptoms was 65.5%. Thirty-five (55.6%) adults with PDD responded that they were aware of having ADHD symptoms at the level of the relevant diagnostic criteria. Conclusions: The present study is the first to examine the frequency of objective and perceived ADHD symptoms in adults with PDD in Japan. Our results show that both objective and perceived ADHD symptoms frequently appear in a large number of adults with PDD. This suggests that it is necessary to attend to concomitant ADHD symptoms in the medical care of adults with PDD.展开更多
Prefrontal dysfunction in patients with attention-deficit/hyperactivity disorder (AD/HD) has been repeatedly detected on a behavioral level, and various brain-imaging studies have elucidated the pathophysiology of AD/...Prefrontal dysfunction in patients with attention-deficit/hyperactivity disorder (AD/HD) has been repeatedly detected on a behavioral level, and various brain-imaging studies have elucidated the pathophysiology of AD/HD. Recent advances in near-infrared spectroscopy (NIRS) have enabled noninvasive investigations of brain function in various mental disorders, especially major depression, schizophrenia, and bipolar disorder. The objective of this preliminary study was to use NIRS to evaluate changes in frontal lobe blood flow in post childhood or adult patients with AD/HD symptoms. The subjects included five patients with a range of mental disorders and AD/HD symptoms, and a matched (age, sex, and dominant hand) control group of five healthy subjects. We compared the changes in cerebral blood flow during verbal fluency tasks between the two groups. The duration of the elevated oxygenated hemoglobin was notably shorter in the AD/HD group than that in the healthy control group. We suggest that the shorter elevation durations of oxygenated hemoglobin concentrations might be a biological indicator for post childhood or adult AD/HD or of impaired executive functioning.展开更多
Objective: The present study compared results on the Wechsler Adult Intelligence Scale-Revised (WAIS-R) among adult patients with attention-deficit/hyperactivity disorder (AD/HD) and those with Asperger’s disorder (A...Objective: The present study compared results on the Wechsler Adult Intelligence Scale-Revised (WAIS-R) among adult patients with attention-deficit/hyperactivity disorder (AD/HD) and those with Asperger’s disorder (AD). Method: WAIS-R results were compared between 16 adults with AD/HD (8 men and 8 women;mean age, 33.81 years;mean full-scale IQ, 101.5) and 15 adults with AD (12 men and 3 women;mean age, 30.93 years;mean full-scale IQ, 104.6). Results: Verbal IQ was significantly higher than performance IQ in the AD group. Among various subtests, scores were the highest for similarities in the AD/HD group and for block design in the AD group. Picture completion test scores were the lowest scores obtained in both groups. A comparison of subtest scores between the AD/HD and AD groups showed scores for information to be significantly higher in the AD group than in the AD/HD group. Conclusions: Our results suggest that there are no differences in verbal IQ, performance IQ, and full-scale IQ scores (except for scores on the information subtest) among adult patients with AD/HD compared with adult patients with AD.展开更多
BACKGROUND Children with attention-deficit/hyperactivity disorder(ADHD)often exhibit behaviour challenges and deficits in executive functions(EF).Psychostimulant medications[e.g.,methylphenidate(MPH)]are commonly pres...BACKGROUND Children with attention-deficit/hyperactivity disorder(ADHD)often exhibit behaviour challenges and deficits in executive functions(EF).Psychostimulant medications[e.g.,methylphenidate(MPH)]are commonly prescribed for children with ADHD and are considered effective in 70%of the cases.Furthermore,only a handful of studies have investigated the long-term impact of MPH medication on EF and behaviour.AIM To evaluate behaviour and EF challenges in children with ADHD who were involved in an MPH treatment trial across three-time points.METHODS Thirty-seven children with ADHD completed a stimulant medication trial to study the short-and long-term impact of medication.Children with ADHD completed three neuropsychological assessments[Continuous Performance Test(CPT)-II,Digit Span Backwards and Spatial Span Backwards].Parents of children with ADHD completed behaviour rating scales[Behaviour Rating Inventory of Executive Functioning(BRIEF)and Behaviour Assessment System for Children-Second Edition(BASC-2)].Participants were evaluated at:(1)Baseline(no medication);and(2)Best-dose(BD;following four-week MPH treatment).Additionally,18 participants returned for a long-term naturalistic follow up(FU;up to two years following BD).RESULTS Repeated measure analyses of variance found significant effects of time on two subscales of BRIEF and four subscales of BASC-2.Neuropsychological assessments showed some improvement,but not on all tasks following the medication trial.These improvements did not sustain at FU,with increases in EF and behaviour challenges,and a decline in performance on the CPT-II task being observed.CONCLUSION Parents of children with ADHD reported improvements in EF and behaviours during the MPH trial but were not sustained at FU.Combining screening tools and neuropsychological assessments may be useful for monitoring medication responses.展开更多
Objective: This study investigates the auxiliary role of resting-state electroencephalography (EEG) in the clinical diagnosis of attention-deficit hyperactivity disorder (ADHD) using machine learning techniques. Metho...Objective: This study investigates the auxiliary role of resting-state electroencephalography (EEG) in the clinical diagnosis of attention-deficit hyperactivity disorder (ADHD) using machine learning techniques. Methods: Resting-state EEG recordings were obtained from 57 children, comprising 28 typically developing children and 29 children diagnosed with ADHD. The EEG signal data from both groups were analyzed. To ensure analytical accuracy, artifacts and noise in the EEG signals were removed using the EEGLAB toolbox within the MATLAB environment. Following preprocessing, a comparative analysis was conducted using various ensemble learning algorithms, including AdaBoost, GBM, LightGBM, RF, XGB, and CatBoost. Model performance was systematically evaluated and optimized, validating the superior efficacy of ensemble learning approaches in identifying ADHD. Conclusion: Applying machine learning techniques to extract features from resting-state EEG signals enabled the development of effective ensemble learning models. Differential entropy and energy features across multiple frequency bands proved particularly valuable for these models. This approach significantly enhances the detection rate of ADHD in children, demonstrating high diagnostic efficacy and sensitivity, and providing a promising tool for clinical application.展开更多
Sleep disturbances and disorders are commonly associated with attention-deficit/hyperactivity disorder(ADHD),with affected children frequently experiencing delayed sleep onset,frequent nighttime awakenings,morning fat...Sleep disturbances and disorders are commonly associated with attention-deficit/hyperactivity disorder(ADHD),with affected children frequently experiencing delayed sleep onset,frequent nighttime awakenings,morning fatigue,and excessive daytime sleepiness.A bidirectional relationship exists between ADHD and sleep disturbances:Sleep deprivation is linked to increased inattention and emotional dysregulation,while evening hyperactivity and impulsivity may contribute to difficulty falling asleep.Central nervous system stimulants remain the first-line treatment for managing ADHD symptoms;however,insomnia can be a common side effect.Notably,newer and long-acting stimulants formulations have demonstrated extended benefit into evening with limited impact on sleep in recent studies.This narrative review summarizes the various sleep disorders associated with ADHD,outlines clinical approaches for sleep assessment,and evaluates the impact of ADHD treatments on sleep.It also highlights both nonpharmacological and pharmacological interventions for managing sleep problems in children with ADHD.Finally,the review offers practical recommendations to help clinicians optimize both sleep and daytime functioning in patients with ADHD.ADHD should be conceptualized as a 24-hour disorder,requiring integrated treatment strategies that address both daytime symptoms and nighttime sleep challenges.展开更多
To the editor:Adverse home environments(AHE),characterised by family conflict,parental separation or dysfunctional parenting,are linked to negative mental health outcomes in children and adults.12 AHE disproportionate...To the editor:Adverse home environments(AHE),characterised by family conflict,parental separation or dysfunctional parenting,are linked to negative mental health outcomes in children and adults.12 AHE disproportionately affect children with neurodevelopmental disorders such as attention-deficit/hyperactivity disorder(ADHD),which is characterised by inattention,hyperactivity/impulsivity and functional impairments.3 Apart from core symptoms,including inattention and hyperactivity,disruptive behaviour disorders(DBD),such as oppositional defiant disorder(ODD)and conduct disorder(CD),may be associated with AHE.Conduct problems are risk factors for ODD.And CD has become a main concern for childhood mental health.展开更多
Attention deficit hyperactivity disorder(ADHD)turns into a common neuro progressional disorder.Although gender identity has obtained increasing attention in ADHD researches,its role in ADHD presentation and treatment ...Attention deficit hyperactivity disorder(ADHD)turns into a common neuro progressional disorder.Although gender identity has obtained increasing attention in ADHD researches,its role in ADHD presentation and treatment response remains underexplored.Our review seeks to mainly delve into the effect of gender identity on ADHD,exploring the unique needs of individuals with various gender identities in the context of ADHD symptoms,diagnostic assessment,and treatment,with the goal of supplying theoretical support and practical recommendations for future research and clinical practice.The primary content includes,specifically:(1)Symptom expression differences:Gender identity significantly affects ADHD symptoms;male-identified individuals commonly perform worse in task orientation and attention stability,while female-identified individuals may demonstrate more variability in attention control and executive functions;(2)Diagnosis and treatment:Clinical practice generally neglects the impact of gender identity on ADHD management,with personalized needs of gender-identified individuals frequently not adequately addressed,potentially,affecting treatment outcomes;and(3)Future research directions:Future studies should further assess how gender identity affects the specific mechanisms of ADHD,conduct researches in multicultural contexts,and engage in long-term follow-up studies to evaluate the long-term impact of gender identity on ADHD progression.Besides,enhanced funding and public education on the relationship between gender identity and ADHD are needed to advance the field.展开更多
基金Supported by Natural Science Foundation of Shanghai,No.17ZR1431400National Key R and D Program of China,No.2017YFA0103902.
文摘Sotos syndrome is characterized by overgrowth features and is caused by alterations in the nuclear receptor binding SET domain protein 1 gene.Attentiondeficit/hyperactivity disorder(ADHD)is considered a neurodevelopment and psychiatric disorder in childhood.Genetic characteristics and clinical presentation could play an important role in the diagnosis of Sotos syndrome and ADHD.Magnetic resonance imaging(MRI)has been used to assess medical images in Sotos syndrome and ADHD.The images process is considered to display in MRI while wavelet fusion has been used to integrate distinct images for achieving more complete information in single image in this editorial.In the future,genetic mechanisms and artificial intelligence related to medical images could be used in the clinical diagnosis of Sotos syndrome and ADHD.
文摘Attention-deficit/hyperactivity disorder(ADHD)is one of the most common neurodevelopmental disorders of childhood,yet its diagnosis remains complex and fraught with challenges.Pediatricians,often the first point of contact for concerned families,play a pivotal role in the diagnostic process.However,they face numerous obstacles that can hinder accurate and timely diagnosis,particularly in resource-limited or culturally diverse settings such as the Middle East and North Africa(MENA)and Arabian Gulf regions.This narrative review explores the key challenges pediatricians face in diagnosing ADHD and highlights practical and emerging solutions.The article offers both a global perspective and a contextualized view relevant to the MENA region.A narrative literature review was conducted using PubMed,Scopus,and Google Scholar,focusing on peer-reviewed studies,clinical guidelines,and epidemiological data from 2010 to 2025 related to pediatric ADHD diagnosis,especially in MENA regions.The review identifies six major diagnostic barriers:(1)Symptom overlap with other conditions[e.g.,autism spectrum disorder(ASD),anxiety,learning disabilities];(2)Reliance on subjective informant reports;(3)Cultural and societal influences including stigma and gender bias;(4)Variability in ADHD training and time constraints in clinical practice;(5)Limited access to multidisciplinary evaluations;and(6)Systemic referral and communication inefficiencies.Comorbidities are highly prevalent and frequently complicate the diagnostic picture.Delayed or inaccurate diagnosis can lead to academic underperformance,family stress,missed interventions,and long-term psychological consequences.Emerging solutions include digital screening tools,artificial intelligence-assisted analysis,structured reporting platforms,and improved training and referral models.Regional data from the Arabian Gulf highlight variable prevalence rates(1.3%-22%)and underscore the need for culturally sensitive diagnostic strategies.To improve diagnostic accuracy and patient outcomes,pediatricians must be supported through better training,interdisciplinary collaboration,validated tools,and policy-level reforms.Tailoring these approaches to local contexts will be key to addressing the growing burden of ADHD,particularly in the MENA region.
基金Supported by the Shenzhen Science and Technology Program,No.RCYX20221008092849069The Guangdong High-Level Hospital Construction Fund.
文摘Attention-deficit/hyperactivity disorder(ADHD)is increasingly conceptualized as a dynamic neurodevelopmental condition,marked by fluctuating symptom trajectories across development rather than the traditional static patterns of persistence or remission.This review synthesizes empirical evidence on the varied trajectories of ADHD symptoms-including late-onset,partial remission,and recurrent fluctuation patterns-and underscores their clinical significance in longterm functioning.We adopt a multifactorial framework to explore how genetic,environmental,and gene–environment interactions contribute to the emergence and evolution of ADHD symptoms over time.In addition,we consider how medication-related variables-particularly tolerance and adherence-may influence symptom fluctuation.Characterizing these developmental dynamics offers critical guidance for designing flexible,personalized interventions that align with individual trajectories and transitional vulnerabilities.
文摘BACKGROUND Sotos syndrome is an autosomal dominant disorder,whereas attention-deficit/hyperactivity disorder(ADHD)is a neurodevelopmental condition.This report aimed to summarize the clinical and genetic features of a pediatric case of Soros syndrome and ADHD in a child exhibiting precocious puberty.CASE SUMMARY The patient presented with accelerated growth and advanced skeletal maturation;however,she lacked any distinct facial characteristics related to specific genetic disorders.Genetic analyses revealed a paternally inherited heterozygous synonymous mutation[c.4605C>T(p.Arg1535Arg)].Functional analyses suggested that this mutation may disrupt splicing,and bioinformatics analyses predicted that this mutation was likely pathogenic.After an initial diagnosis of Sotos syndrome,the patient was diagnosed with ADHD during the follow-up period at the age of 8 years and 7 months.CONCLUSION The potential for comorbid ADHD in Sotos syndrome patients should be considered to avoid the risk of a missed diagnosis.
文摘Background: Working memory is an executive function that plays an important role in many aspects of daily life, and its impairment in patients with attention-deficit/hyperactivity disorder (ADHD) affects quality of life. The dorsolateral prefrontal cortex (DLPFC) has been a good target site for transcranial direct current stimulation (tDCS) due to its intense involvement in working memory. In our 2018 study, tDCS improved visual-verbal working memory in healthy subjects. Objective: This study examines the effects of tDCS on ADHD patients, particularly on verbal working memory. Methods: We conducted an experiment involving verbal working memory of two modalities, visual and auditory, and a sustained attention task that could affect working memory in 9 ADHD patients. Active or sham tDCS was applied to the left DLPFC in a single-blind crossover design. Results: tDCS significantly improved the accuracy of visual-verbal working memory. In contrast, tDCS did not affect auditory-verbal working memory and sustained attention. Conclusion: tDCS to the left DLPFC improved visual-verbal working memory in ADHD patients, with important implications for potential ADHD treatments.
基金supported by the Eunice Kennedy Shriver National Institute of Child Health & Human Development of the National Institutes of Health(NIH,P30HD071593)
文摘Attention-deficit/hyperactivity disorder （ADHD） is a neurodevelopmental disorder with a long-term impact on functioning, productivity and quality of life of patients. This impact is largely due to the symptoms of inattentiveness. However, despite its impairing role in the lives of ADHD patients, inattentiveness has been studied relatively less frequently than have symptoms of impulsivity/hyperactivity and problems with executive function. This review therefore seeks to integrate the neuropsychological theories and current findings in the research fields of neuropsychology, neurophysiology, and neuroimaging, in an attempt to gain a more complete understanding of the role that inattentiveness plays in ADHD, as well as to suggest directions for future studies. The need for a more comprehensive understanding of inattentiveness and ADHD, which integrates findings from each of the three disciplines mentioned above, is emphasized.
基金supported by the Commonwealth Sciences Foundation, Ministry of Health, China (200802073)the National Basic Research Development Program, Ministry of Science and Technology, China (2007BAI17B03)+1 种基金the National Natural Sciences Foundation of China (30970802, 81000593, 81020108022, 81271652)the Open Research Fund of the State Key Laboratory of Cognitive Neuroscience and Learning
文摘Regional homogeneity（ReHo）and the amplitude of low-frequency fluctuation（ALFF）are two approaches to depicting different regional characteristics of resting-state functional magnetic resonance imaging（RS-fMRI）data.Whether they can complementarily reveal brain regional functional abnormalities in attention-deficit/hyperactivity disorder（ADHD）remains unknown.In this study,we applied ReHo and ALFF to 23 medication-na ve boys diagnosed with ADHD and 25 age-matched healthy male controls using whole-brain voxel-wise analysis.Correlation analyses were conducted in the ADHD group to investigate the relationship between the regional spontaneous brain activity measured by the two approaches and the clinical symptoms of ADHD.We found that the ReHo method showed widely-distributed differences between the two groups in the fronto-cingulo-occipitocerebellar circuitry,while the ALFF method showed a difference only in the right occipital area.When a larger smoothing kernel and a more lenient threshold were used for ALFF,more overlapped regions were found between ALFF and ReHo,and ALFF even found some new regions with group differences.The ADHD symptom scores were correlated with the ReHo values in the right cerebellum,dorsal anterior cingulate cortex and left lingual gyrus in the ADHD group,while no correlation was detected between ALFF and ADHD symptoms.In conclusion,ReHo may be more sensitive to regional abnormalities,at least in boys with ADHD,than ALFF.And ALFF may be complementary to ReHo in measuring local spontaneous activity.Combination of the two may yield a more comprehensive pathophy-siological framework for ADHD.
基金Natural Science Foundation of Ningbo(Grant No.2018A610245)。
文摘This study retrospectively analyzed the medication prescriptions of children diagnosed with attention-deficit/hyperactivity disorder(ADHD) in Ningbo Psychiatric Hospital and Ningbo Women and Children’s Hospital from March 2018 to September 2020 and compared the drug retention rate of methylphenidate hydrochloride and atomoxetine hydrochloride. The prescription automatic screening system was used to screen the prescriptions in children with ADHD. Kaplan-Meier regression analysis was used to compare prescription retention rates between the two regimens after adjusting for gender, age, body weight, and prescription cost. The mean age of the methylphenidate hydrochloride group was 8.75 ± 2.16 years, and the monthly prescription cost was 327.37 ± 146.64 RMB. The average age of the atomoxetine group was 8.33 ± 1.73 years, and the monthly prescription cost was 363.15 ± 154.90 ￥. There were some differences in the age of enrollment and the monthly prescription cost between the two regimens(all P < 0.01). Moreover, the retention rate of methylphenidate hydrochloride was higher compared with atomoxetine hydrochloride within 18 months. Kaplan-Meier regression analysis showed that this trend was significant(Tarone-ware, Chi-square value = 14.893, P < 0.001). Prescription costs might be a factor affecting drug retention. This study found that the retention rates were decreased month by month in children with ADHD, and after 5 months, the retention rates were 52.20% and 41.22%, respectively, far below the recommended levels of the guidelines.
基金supported by OTKA K108336 grantthe János Bolyai Research Scholarship of the Hungarian Academy of Sciences.
文摘AIM To investigate suicidality and attention-deficit/hyperactivity disorder(ADHD),this paper aims to systematically review the literature as an extension of previous reviews.METHODS We searched five databases(Ovid MEDLINE,Psychinfo,PubM ed,Scopus,Web of Science)with two categories of search terms:(1)suicide;suicidal;suicide behavior;suicide attempt;suicidal thought;and(2)ADHD.RESULTS The search resulted 26 articles.There is a positive association between ADHD and suicidality in both sexes and in all age groups.Comorbid disorders mediate between suicidality and ADHD.CONCLUSION Recognizing ADHD,comorbid conditions and suicidality is important in prevention.
文摘BACKGROUND High risk of alcohol and drug use disorders in people with attentiondeficit/hyperactivity disorder(ADHD)calls for exploratory research of relationships with clinical features of ADHD.AIM To estimate prevalence of alcohol/drug use disorders and associations with ADHD symptom severity and emotional dysregulation,in adults with ADHD.METHODS This observational cross-sectional clinical study consisted of patients admitted to a private psychiatric outpatient clinic in Oslo,Norway(2014-2018).Five-hundred and fifty-eight eligible patients diagnosed with ADHD(Diagnostic and Statistical Manual of Mental Disorders,Fifth Edition(DSM-5)criteria)agreed to participate.Alcohol and drug use disorders were diagnosed using the Mini International Neuropsychiatric Interview(MINI).Dependence and abuse were merged into“use”disorder as in MINI version 7.0/DSM-5.Questions were related both to lifetime and the past 12-mo.ADHD severity was assessed by the Adult ADHD Self Report Scale(ASRS).Subdivisions of the ASRS questionnaire as inattentive items and hyperactive/impulsivity items were recorded separately.Emotional dysregulation was assessed by the eight-item version of Barkley’s Current Behavior Scale-Self Report.RESULTS The 12-mo prevalence was 5.3%for alcohol use disorder and 13.7%for drug use disorder.The lifetime prevalence was 12.0%for alcohol use disorder and 27.7%for drug use disorder.Men had higher rates of both alcohol use disorder and drug use disorder compared to women.The prevalence of drug use disorder was more than twice that of alcohol use disorder for both sexes.The drugs most participants reported having used were(in descending order):Amphetamine(19.1%),cannabis(17.1%),cocaine or ecstasy(7.4%),benzodiazepines(7.4%),and heroin or other opioids(2.9%).Lifetime drug use disorder was significantly associated with both hyperactivity-impulsivity symptoms and emotional dysregulation symptom severity.Lifetime alcohol use disorder,on the other hand,was not significantly associated with ADHD symptoms or emotional dysregulation when adjusted for gender and age.CONCLUSION Patients with ADHD have a high lifetime prevalence of drug use disorder,which is associated with higher levels of hyperactivity-impulsivity symptoms and emotional dysregulation.
文摘BACKGROUND Treatment efficacy for attention-deficit/hyperactivity disorder(ADHD)is reported to be poor,possibly due to heterogeneity of ADHD symptoms.Little is known about poor treatment efficacy owing to ADHD heterogeneity.AIM To use generalized structural equation modeling(GSEM)to show how the heterogeneous nature of hyperactivity/impulsivity(H/I)symptoms in ADHD,irritable oppositional defiant disorder(ODD),and the presentation of aggression in children interferes with treatment responses in ADHD.METHODS A total of 231 children and adolescents completed ADHD inattention and H/I tests.ODD scores from the Swanson,Nolan,and Pelham,version IV scale were obtained.The child behavior checklist(CBCL)and parent’s satisfaction questionnaire were completed.The relationships were analyzed by GSEM.RESULTS GSEM revealed that the chance of ADHD remission was lower in children with a combination of H/I symptoms of ADHD,ODD symptoms,and childhood aggressive behavior.ODD directly mediated ADHD symptom severity.The chance of reaching remission based on H/I symptoms of ADHD was reduced by 13.494%[=exp(2.602)]in children with comorbid ADHD and ODD[odds ratio(OR)=2.602,95%confidence interval(CI):1.832-3.373,P=0.000]after adjusting for the effects of other factors.Childhood aggression mediated ODD symptom severity.The chance of reaching remission based on ODD symptoms was lowered by 11.000%[=1-exp(-0.117)]in children with more severe baseline symptoms of aggression based on the CBCL score at study entry[OR=-0.117,95%CI:(-0.190)-(-0.044),P=0.002].CONCLUSION Mediation through ODD symptoms and aggression may influence treatment effects in ADHD after adjusting for the effects of baseline ADHD symptom severity.More attention could be directed to the early recognition of risks leading to ineffective ADHD treatment,e.g.,symptoms of ODD and the presentation of aggressive or delinquent behaviors and thought problems in children with ADHD.
文摘Background: Informed consent forms and clinical study participation explanations contain many specialized words including medical terms that are difficult to understand. The difficulty is particularly obvious for children with developmental disorders who show attention or similar problems. This study quantitatively evaluated the decision-making ability of these children using the Wechsler Intelligence Scale for Children-III (WISC-III) as a preliminary study for a multi-faceted investigation that would also use physiological indices. Methods: Participants were 11 children with Attention Deficit/Hyperactivity Disorder (AD/HD). The WISC-III was used for quantitative evaluation of their decision-making ability. Results of intelligence quotients (IQs), group indices, and subtest scores were analyzed. Results: The mean Performance IQ was four points lower than the mean Verbal IQ. The mean score for the Processing Speed index was lower by more than one standard deviation (SD). The mean scores for the Coding and Object Assembly subtests were lower by more than two SDs. Conclusion: The WISC-III results for IQ and group indices suggested the efficacy of auditory explanations. In addition, the subtest results suggested the necessity to pay sufficient attention to risk-benefit weighting in explanations. These findings suggested that the decision-making ability of children with AD/HD could be assessed using the WISC-III.
文摘Aims: This study was designed to verify the proportion of Japanese adults with pervasive developmental disorder (PDD) who met the diagnostic criteria (other than E) for attention-deficit/hyperactivity disorder (ADHD) in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR). Furthermore, we examined to what extent adults with PDD think that they exhibit ADHD symptoms. Methods: We developed an original Japanese self-report questionnaire to determine the presence or absence of 18 symptoms from the diagnostic criteria for ADHD in the DSM-IV-TR. We administered the questionnaire to 64 adults with high-functioning PDD (45 men and 19 women) and 21 adults with ADHD (10 men and 11 women), aged 18 to 59 years, with a full-scale intelligence quotient ≥75. Target patients were evaluated for ADHD by their psychiatrists. Results: Twenty-nine (45.3%) adults with PDD also had ADHD. The percentage of these adults who had over six perceived inattention symptoms from the DSM-IV-TR was 96.6%. The percentage of these adults who had over six perceived hyperactivity-impulsivity symptoms was 65.5%. Thirty-five (55.6%) adults with PDD responded that they were aware of having ADHD symptoms at the level of the relevant diagnostic criteria. Conclusions: The present study is the first to examine the frequency of objective and perceived ADHD symptoms in adults with PDD in Japan. Our results show that both objective and perceived ADHD symptoms frequently appear in a large number of adults with PDD. This suggests that it is necessary to attend to concomitant ADHD symptoms in the medical care of adults with PDD.
文摘Prefrontal dysfunction in patients with attention-deficit/hyperactivity disorder (AD/HD) has been repeatedly detected on a behavioral level, and various brain-imaging studies have elucidated the pathophysiology of AD/HD. Recent advances in near-infrared spectroscopy (NIRS) have enabled noninvasive investigations of brain function in various mental disorders, especially major depression, schizophrenia, and bipolar disorder. The objective of this preliminary study was to use NIRS to evaluate changes in frontal lobe blood flow in post childhood or adult patients with AD/HD symptoms. The subjects included five patients with a range of mental disorders and AD/HD symptoms, and a matched (age, sex, and dominant hand) control group of five healthy subjects. We compared the changes in cerebral blood flow during verbal fluency tasks between the two groups. The duration of the elevated oxygenated hemoglobin was notably shorter in the AD/HD group than that in the healthy control group. We suggest that the shorter elevation durations of oxygenated hemoglobin concentrations might be a biological indicator for post childhood or adult AD/HD or of impaired executive functioning.
文摘Objective: The present study compared results on the Wechsler Adult Intelligence Scale-Revised (WAIS-R) among adult patients with attention-deficit/hyperactivity disorder (AD/HD) and those with Asperger’s disorder (AD). Method: WAIS-R results were compared between 16 adults with AD/HD (8 men and 8 women;mean age, 33.81 years;mean full-scale IQ, 101.5) and 15 adults with AD (12 men and 3 women;mean age, 30.93 years;mean full-scale IQ, 104.6). Results: Verbal IQ was significantly higher than performance IQ in the AD group. Among various subtests, scores were the highest for similarities in the AD/HD group and for block design in the AD group. Picture completion test scores were the lowest scores obtained in both groups. A comparison of subtest scores between the AD/HD and AD groups showed scores for information to be significantly higher in the AD group than in the AD/HD group. Conclusions: Our results suggest that there are no differences in verbal IQ, performance IQ, and full-scale IQ scores (except for scores on the information subtest) among adult patients with AD/HD compared with adult patients with AD.
基金Supported by the Alberta Children's Hospital Foundation,Werklund School of Education,University of Calgary.
文摘BACKGROUND Children with attention-deficit/hyperactivity disorder(ADHD)often exhibit behaviour challenges and deficits in executive functions(EF).Psychostimulant medications[e.g.,methylphenidate(MPH)]are commonly prescribed for children with ADHD and are considered effective in 70%of the cases.Furthermore,only a handful of studies have investigated the long-term impact of MPH medication on EF and behaviour.AIM To evaluate behaviour and EF challenges in children with ADHD who were involved in an MPH treatment trial across three-time points.METHODS Thirty-seven children with ADHD completed a stimulant medication trial to study the short-and long-term impact of medication.Children with ADHD completed three neuropsychological assessments[Continuous Performance Test(CPT)-II,Digit Span Backwards and Spatial Span Backwards].Parents of children with ADHD completed behaviour rating scales[Behaviour Rating Inventory of Executive Functioning(BRIEF)and Behaviour Assessment System for Children-Second Edition(BASC-2)].Participants were evaluated at:(1)Baseline(no medication);and(2)Best-dose(BD;following four-week MPH treatment).Additionally,18 participants returned for a long-term naturalistic follow up(FU;up to two years following BD).RESULTS Repeated measure analyses of variance found significant effects of time on two subscales of BRIEF and four subscales of BASC-2.Neuropsychological assessments showed some improvement,but not on all tasks following the medication trial.These improvements did not sustain at FU,with increases in EF and behaviour challenges,and a decline in performance on the CPT-II task being observed.CONCLUSION Parents of children with ADHD reported improvements in EF and behaviours during the MPH trial but were not sustained at FU.Combining screening tools and neuropsychological assessments may be useful for monitoring medication responses.
基金This study received financial support from the Jilin Province Health and Technology Capacity Enhancement Project(Project Number:222Lc132).
文摘Objective: This study investigates the auxiliary role of resting-state electroencephalography (EEG) in the clinical diagnosis of attention-deficit hyperactivity disorder (ADHD) using machine learning techniques. Methods: Resting-state EEG recordings were obtained from 57 children, comprising 28 typically developing children and 29 children diagnosed with ADHD. The EEG signal data from both groups were analyzed. To ensure analytical accuracy, artifacts and noise in the EEG signals were removed using the EEGLAB toolbox within the MATLAB environment. Following preprocessing, a comparative analysis was conducted using various ensemble learning algorithms, including AdaBoost, GBM, LightGBM, RF, XGB, and CatBoost. Model performance was systematically evaluated and optimized, validating the superior efficacy of ensemble learning approaches in identifying ADHD. Conclusion: Applying machine learning techniques to extract features from resting-state EEG signals enabled the development of effective ensemble learning models. Differential entropy and energy features across multiple frequency bands proved particularly valuable for these models. This approach significantly enhances the detection rate of ADHD in children, demonstrating high diagnostic efficacy and sensitivity, and providing a promising tool for clinical application.
文摘Sleep disturbances and disorders are commonly associated with attention-deficit/hyperactivity disorder(ADHD),with affected children frequently experiencing delayed sleep onset,frequent nighttime awakenings,morning fatigue,and excessive daytime sleepiness.A bidirectional relationship exists between ADHD and sleep disturbances:Sleep deprivation is linked to increased inattention and emotional dysregulation,while evening hyperactivity and impulsivity may contribute to difficulty falling asleep.Central nervous system stimulants remain the first-line treatment for managing ADHD symptoms;however,insomnia can be a common side effect.Notably,newer and long-acting stimulants formulations have demonstrated extended benefit into evening with limited impact on sleep in recent studies.This narrative review summarizes the various sleep disorders associated with ADHD,outlines clinical approaches for sleep assessment,and evaluates the impact of ADHD treatments on sleep.It also highlights both nonpharmacological and pharmacological interventions for managing sleep problems in children with ADHD.Finally,the review offers practical recommendations to help clinicians optimize both sleep and daytime functioning in patients with ADHD.ADHD should be conceptualized as a 24-hour disorder,requiring integrated treatment strategies that address both daytime symptoms and nighttime sleep challenges.
基金supported by National Natural Science Foundation Youth Project (81901386)the Fundamental Research Funds for the Central Universities (YG2025ZD07)+5 种基金the National Science and Technology Innovation 2030 Major Project of China (2021ZD0203900)National Natural Science Foundation of China (NSFC) grant (82422029)the Science and Technology Commission of Shanghai Municipality (24Y22800200, 22QA1407900)NSFC grant (82271530)Innovation teams of high-level universities in Shanghaithe Scientific Research and Innovation Team of Liaoning Normal University (24TD004).
文摘To the editor:Adverse home environments(AHE),characterised by family conflict,parental separation or dysfunctional parenting,are linked to negative mental health outcomes in children and adults.12 AHE disproportionately affect children with neurodevelopmental disorders such as attention-deficit/hyperactivity disorder(ADHD),which is characterised by inattention,hyperactivity/impulsivity and functional impairments.3 Apart from core symptoms,including inattention and hyperactivity,disruptive behaviour disorders(DBD),such as oppositional defiant disorder(ODD)and conduct disorder(CD),may be associated with AHE.Conduct problems are risk factors for ODD.And CD has become a main concern for childhood mental health.
基金Supported by the Central Guiding Local Science and Technology Development Fund Project,No.YDZX2022091。
文摘Attention deficit hyperactivity disorder(ADHD)turns into a common neuro progressional disorder.Although gender identity has obtained increasing attention in ADHD researches,its role in ADHD presentation and treatment response remains underexplored.Our review seeks to mainly delve into the effect of gender identity on ADHD,exploring the unique needs of individuals with various gender identities in the context of ADHD symptoms,diagnostic assessment,and treatment,with the goal of supplying theoretical support and practical recommendations for future research and clinical practice.The primary content includes,specifically:(1)Symptom expression differences:Gender identity significantly affects ADHD symptoms;male-identified individuals commonly perform worse in task orientation and attention stability,while female-identified individuals may demonstrate more variability in attention control and executive functions;(2)Diagnosis and treatment:Clinical practice generally neglects the impact of gender identity on ADHD management,with personalized needs of gender-identified individuals frequently not adequately addressed,potentially,affecting treatment outcomes;and(3)Future research directions:Future studies should further assess how gender identity affects the specific mechanisms of ADHD,conduct researches in multicultural contexts,and engage in long-term follow-up studies to evaluate the long-term impact of gender identity on ADHD progression.Besides,enhanced funding and public education on the relationship between gender identity and ADHD are needed to advance the field.
